摘要
目的分析早产儿脑室周围白质软化(PVL)的超声表现以及预后.方法对入住福建省妇幼保健院新生儿科所有早产儿进行常规床边头颅B超检查,对确诊为PVL的早产儿进行PVL超声图像分析并定期随访.结果 1996年底至2004年7月间经常规床边B超检查确诊为PVL的早产儿共20例,其中19例初次B超检查时间为(4.20±0.85)d,均在超声中表现为双侧脑室前角、体部或三角部外上方对称性强回声区.1例因故迟至29日龄进行初次B超检查,显示双侧侧脑室三角部外上方已呈多发小囊腔改变.10例于(23.6±6.1)d在原回声增强区呈现多个低回声或无回声囊腔,直径范围在2～19.5mm,其中2例显示囊腔分别于41日龄和67日龄消失.除早期死亡、自动出院及失访12例外,余8例患儿中,发生脑瘫4例,疑似脑瘫1例,其中2例伴有智测评分低下;仅3例3～7个月龄随访时暂未发现异常.结论 PVL的超声表现十分典型.由于PVL患儿预后不良,对早产儿在生后早期进行常规床边头颅B超检查很有必要.
Objective To explore sonographic manifestation and prognosis in premature infants with periventricular leukomalacia (PVL).Methods Routine bedside cranial ultrasonic detection was done in all hospitalized premature infants.Sonographic manifestation and follow-up results were analyzed in premature infants with PVL.Results PVL was diagnosed with ultrasonography in 20 cases from the end of 1996 to July,2004.The initial cranial ultrasonic detection was (4.2±0.85)d in 19 cases.It was noticed that the intense echo dense located in upper-lateral to either frontal horns, bodies or trigones of the bilateral ventricles on ultrasound images in all 19 cases with PVL.Only one case manifested multiple periventricular cysts on his 29 day-aged initial ultrasonography.10 cases developed multiple periventricular cysts in the original echodensity areas at an average of (23.6±6.1) days old with the diameters of cyst ranged from 2 to 19.5 mm.The cysts was absorbed in one case at 41 days old and another at 67 days old,respectively.12 of 20 cases with PVL were either death in the early neonatal stage,quit therapy for leaving hospital or lost contact after being discharged from the hospital.In the rest 8 PVL cases,4 cases developed cerebral palsy and one case was suspected as cerebral palsy with mental retardation.No obviously abnormal finding was observed only in three cases with PVL at their three- to seven-month-old follow-up results.Conclusion There is a characteristic sonographic manifestation of PVL.Because of poor prognosis of PVL,it will be necessary to undertake routine bedside cranial ultrasonic detection for all premature infants early after birth.
出处
《中国实用儿科杂志》
CSCD
北大核心
2005年第2期78-80,i003,共4页
Chinese Journal of Practical Pediatrics
关键词
早产儿
脑室周围白质软化
头颅B超
Premature infant Periventricular leukomalacia Cranial sonography
